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Provider Notice Issued 10/31/2022

Date:    October 31, 2022    

To:       Enrolled Physicians, Advanced Practice Registered Nurses, Physician Assistants, Local Health Departments, Encounter Rate Clinics, Federally Qualified Health Centers, Rural Health Clinics, Hospitals, and Pharmacies        

Re:      COVID-19 Bivalent Booster Vaccination Age Range Lowered


This notice provides an update in coverage of the new COVID-19 bivalent boosters. The update applies to claims for customers covered under traditional Medicaid fee-for-service (FFS) and the HealthChoice Illinois (HCI) managed care organization (MCO) plans.


By practitioner provider notice dated September 30, 2022, and pharmacy provider notice dated October 5, 2022, the minimum age for the Pfizer-BioNTech bivalent booster was identified as 12 years. The Moderna bivalent booster minimum age was 18 years.


Effective October 12, 2022, the U.S. Food and Drug Administration (FDA), in association with the Center of Disease Control (CDC), authorized the administration of the Pfizer-BioNTech bivalent booster beginning at 5 years of age and the Moderna bivalent booster beginning at 6 years of age. All other information in the above-referenced provider notices remains the same.


The HFS COVID-19 Fee Schedule has been updated. Questions regarding vaccine administration may be directed to the Bureau of Professional and Ancillary Services at 877-782-5565 for the FFS program, or the applicable HCI MCO plan.




Kelly Cunningham, Administrator

Division of Medical Programs







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Illinois Department of Healthcare and Family Services

JB Pritzker, Governor • Theresa Eagleson, Director

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